Temporal bone and lateral skull base malignancy: experience and results with 81 patients

Abstract

Objective: This study aimed to examine predictive factors and treatment outcome and to devise a staging method for malignant lateral skull base disease.

Study design: The study design was a retrospective review of all lateral skull base surgery cases.

Setting: The study was conducted at a tertiary referral center.

Patients: Of 317 lateral skull base lesions, 81 patients were found to have malignant disease. Three groups were identified, and the data were analyzed according to the following: epithelial malignancies, 30 patients; malignancies of salivary gland origin, 23 patients; and malignancies of mesenchymal origin, 28 patients. The mean age was 48.5 years with a range of 5-83 years. There were 42 males and 39 females. Our mean follow-up time was 54 months with a range of 1-180 months. Forty-three patients were alive without evidence of recurrent disease, 6 were living with disease, 25 were dead of disease, 3 died of other causes, and 4 were lost to follow-up.

Interventions: All patients underwent surgery with curative intent. Forty-two received adjuvant radiation, and 8 received chemotherapy.

Main outcome measures: Treatment failure, survival, cranial nerve deficits, complications, and predictive factors were analyzed.

Results: A 58% treatment success rate was observed. Epithelial and salivary malignancy had a poorer prognosis, and pain and facial nerve dysfunction at presentation carried a worse prognosis.

Conclusions: Lateral skull base malignancy is a rare entity that continues to challenge cranial base surgeons. Cranial nerve deficits and complications are frequent. The success rate of treatment is dependent on histology and disease extent.